Fresh Air Access in the Modern City

Well into the twentieth century, most American hospital designers and builders believed that open space around hospital buildings was a necessity because it allowed direct access of health-giving light and air to the patient rooms and even many of the service areas. As urban real estate became more expensive in the first decades of the twentieth century, available, affordable sites for hospitals grew smaller while at the same time the basic spatial requirements of hospitals increased enormously. With larger-scale buildings having to fit onto ever smaller-scale sites, it was rare for a hospital committee to be able to afford a site large enough to accommodate the necessary structures and still have room for unbuilt space on the site. This pressure to provide open space despite increasingly small, expensive, urban sites pushed many new hospitals to sites on the city boundaries, or even beyond the city limits, where access to fresh air was abundant, but access for patients was difficult. Some hospital designers, however, chose to keep the hospital in the city, near to the patients, and they increasingly relied on their surroundings rather than their own site for open space. Corner lots (with two sides of street exposure) or sites adjacent to parks or rivers could provide fresh air reservoirs without increasing the size of the hospital site. Low-rise or undeveloped surrounding city lots could also provide fresh air access. But the nature of an urban street or of undeveloped third-party sites was far from static and could not be taken for granted. This could create tense situations and uncertain futures. The next three posts give three examples.